Anyone have success with battling the insurance companies (UHC) in getting them to cover cranial bands (helmets) due to multiples? I have read that you have a higher risk and more likely to get plagiocephaly with multiples due to space issues in utero.
We have been concerned about the babies flat heads since they were a few weeks old. The pediatrician hoped it would round out as they spent more time on their stomachs, but after their 4 month checkup referred us to a plastic surgeon for a plagiocephaly evaluation. The plastic surgeon who uses star bands said it is not covered and its $3000 per child plus copays for office visits. I wasn't thrilled with the place, so looked into a few others. DOC bands (also not covered) for $4000 a child and hanger cranial (not covered) but much more affordable at $1500 per child. The hanger cranial place said they would also help us fight the insurance company.
Does anyone have success with Hanger?
Re: Plagiocephaly
The plan says DME is covered, but orthotics to alter a body part aren't covered. They consider the problem "cosmetic".
I was hoping to fight the insurance company with a medically necessary diagnosis, but I think it's essential to start treatment now to get better results so we'll be forced to go with the more affordable option (hanger).
We just started the process of fighting with insurance for the bands and it's looking pretty grim. We also have UHC. Both babies need it and it will be about $5000 (with the "twin discount"). Thanks for the tip about that clause. Any other tips to help fight it?